Mizoguchi Tatsuya, Yokoi Masashi, Shintani Yasuhiro, Yamamoto Junki, Mori Kento, Fujita Hiroshi, Ito Tsuyoshi, Sugiura Tomonori, Seo Yoshihiro
Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
J Cardiol Cases. 2022 Sep;26(3):225-228. doi: 10.1016/j.jccase.2022.04.020. Epub 2022 May 17.
Despite the established safety of BNT162b2 coronavirus disease 2019 (COVID-19) vaccine, some rare but serious complications have been previously reported. Here, we report a rare case of an elderly female who developed subacute pleuropericarditis after the vaccination. An 88-year-old female experienced weight gain and dyspnea three days after the second dose of BNT162b2 vaccination, and one month later, presented to our hospital due to the exacerbation of the symptoms. Computed tomography showed remarkable pericardial and bilateral pleural effusions, and transthoracic echocardiogram visualized collapse signs of right and left atrium which indicates pre-tamponade. Percutaneous drainages of pericardial and pleural effusions stabilized her vital condition and revealed that all of them were exudative, indicating the presence of pleuropericarditis. Finally, we diagnosed this case as COVID-19 vaccine-associated pleuropericarditis because there were no signs of bacterial/viral infection or any other relevant causes except for the vaccination. When the pericardial and pleural effusions are concurrently found after COVID-19 vaccination, vaccine-associated pleuropericarditis should be considered as a differential diagnosis. The aggressive drainage of pericardial and pleural effusions could be helpful not only for diagnosis but also for treatment in the clinical management of COVID-19 vaccine-associated pleuropericarditis.
Although the safety and efficacy of BNT162b2 have been widely accepted, it is clinically important to know the potential risk of side effects. When the pericardial and pleural effusions are concurrently found after the vaccination, coronavirus disease 2019 vaccine-associated pleuropericarditis should be considered as a differential diagnosis.
尽管2019冠状病毒病（COVID-19）疫苗BNT162b2已确定具有安全性，但此前已报告了一些罕见但严重的并发症。在此，我们报告一例老年女性在接种疫苗后发生亚急性胸膜心包炎的罕见病例。一名88岁女性在接种第二剂BNT162b2疫苗三天后出现体重增加和呼吸困难，一个月后因症状加重就诊于我院。计算机断层扫描显示心包和双侧胸腔有大量积液，经胸超声心动图显示左右心房塌陷征象，提示心包填塞前期。心包和胸腔积液的经皮引流稳定了她的生命体征，并显示所有积液均为渗出液，提示存在胸膜心包炎。最后，我们将此病例诊断为COVID-19疫苗相关胸膜心包炎，因为除接种疫苗外，没有细菌/病毒感染或任何其他相关病因的迹象。在COVID-19疫苗接种后同时发现心包和胸腔积液时，应考虑将疫苗相关胸膜心包炎作为鉴别诊断。心包和胸腔积液的积极引流不仅有助于诊断，也有助于COVID-19疫苗相关胸膜心包炎临床治疗。
尽管BNT162b2的安全性和有效性已被广泛接受，但了解其潜在的副作用风险在临床上很重要。在接种疫苗后同时发现心包和胸腔积液时，应考虑将2019冠状病毒病疫苗相关胸膜心包炎作为鉴别诊断。
